Kindly Excuss Me Folks: US Politics Question

[robklurfield]

Bill, on the topic of paying for smokers (who should quit) and fat-asses (who should lose weight), the fundamental premise of insurance, health, casualty or other, is to spread the risk across the largest pool possible to diminish the cost and risk for all. When we start excluding groups from this, it screws up the whole premise. Yes, people with bad habits should be encouraged to reform. But once you start excluding them from the system you run into the slippery slope of what do you exclude next. Pre-existing conditions? Genetic markers? Etc? If we all bear the burden of something as fundamental as caring for health, the cost will likely be controlled better than by letting insurance companies with a mandate for nothing but maximizing quarterly profits determine the rules. I'm all for single payer. I agree that this patch work is likely to cause plenty of problems. I am disappointed that Congress and the President haven't got the guts to push for and educate us about the benefits of single payer.

 

[bmattock]

Bill, you are absolutely right about the current legislation being a patch. And, I might add, a bad one at that.

I am afraid it will do nothing and help precious few, but at enormous cost and with huge government intervention (which is once again the camel's nose under the tent).

 

[bmattock]

Bill, one more minor quibble on the topic of mandates. Our Constitution by virtue of defining that Congress shall make laws and have the power of the purse, gives Congress a mandate to pass laws that reflect the will of the people.

We have a basic disagreement about how our federal government operates that I don't think we can really expound upon in great detail here, especially whilst remaining detached and dispassionate. With respect, I disagree. "Mandate" is just a word used by the majority - of either party - to describe what they're about to shove down our throats with or without the legal right to do so.

Fortunately, I suspect that the current 'mandate' will not survive constitutional scrutiny. Never in history has our federal government mandated that people are forced to purchase any good or service, which both popular versions of this health care proposal do. Mandate it may or may not be, but I doubt it will pass constitutional muster - and that is the final arbiter, whether one subscribes to the viewpoint that it ought to or whether one does not.

 

[robklurfield]

Bill, I was at the National WWII Museum in New Orleans last weekend which was holding a major celebration for the opening of a new building. It was incredibly touching to see some of these WWII vets, not mention some of the younger guys and gals who are vets from more recent times. One of the best ways to support our men and women is to never send them into harm's way without sufficient justification. We've spilled an awful lot of blood of our own the last decade for reasons that are not quite just. I for one, can readily separate my support of our men and women from my anger over our misadventure in Iraq and our neglect of the roots of terrorism that we let slip out of Afganistan into Pakistan. The troops have done their job. I can't say the same thing for our political leadership. The troops in Iraq have performed above the call, but unfortunately they've done so on a fools errand. I almost think that above the thanks we owe them for service and sacrifice, we also owe them an apology for having sent to them to chase non-existent WMD and support corrupt, fractious and violent regimes. They did and are doing their job; it's not their fault that the job was a foolish mistake based on a lie. Troops don't get to pick their mission. We ought to support them even when we don't agree with the mission (and I do support them), but at the same time, we need to hold the political class accountable for horrendous decision making. It's every bit as patriotic to question the war as it is to support the troops who bravely wage it. Hope you'll my humble (civilian) salute to your service.

 

[bmattock]

Bill, on the topic of paying for smokers (who should quit) and fat-asses (who should lose weight), the fundamental premise of insurance, health, casualty or other, is to spread the risk across the largest pool possible to diminish the cost and risk for all. When we start excluding groups from this, it screws up the whole premise. Yes, people with bad habits should be encouraged to reform. But once you start excluding them from the system you run into the slippery slope of what do you exclude next. Pre-existing conditions? Genetic markers? Etc? If we all bear the burden of something as fundamental as caring for health, the cost will likely be controlled better than by letting insurance companies with a mandate for nothing but maximizing quarterly profits determine the rules. I'm all for single payer. I agree that this patch work is likely to cause plenty of problems. I am disappointed that Congress and the President haven't got the guts to push for and educate us about the benefits of single payer.

Private insurers, such as employers, are currently providing benefits to the unhealthy among their employees to clean up their act. Some employers (and I worked for one) have taken it a step further and have chosen to apply financial disincentives (penalties) to those who do not get healthier. And I will tell you that a very close relative (close) lost her health insurance altogether because she was mandated to join a health care 'wellness' group by her employer, she failed to meet the goals set for her by the employer, and thus her health insurance was terminated.

Private employers defend this behavior - claiming that it is their right to control costs for the good of all employees. One can certainly opt-out by finding another job. However, if the federal government is the insurer, and one has no choice but to take that insurance, one cannot opt-out. But one can certainly be denied benefits for the same reason that private insurers use.

It has and does happen in countries that have such systems - those who have 'abused' their bodies are often denied second or third treatments for ailments they could have avoided by living a healthy lifestyle.

"Encouragement" to be healthy will one day be mandated by law. I make this prediction. Others can make of it what they will, but I firmly believe I will one day be able to say "I told you so." It won't happen overnight, but it will happen. I am sorrier still that some people believe it is good and right that the government force us to take care of our bodies.

 

[robklurfield]

Let's agree to disagree and move on to topics related to rangefinder photography. I hereby yield the floor.

 

[bmattock]

It's every bit as patriotic to question the war as it is to support the troops who bravely wage it.

Absolutely it is. I only hold animosity towards those who pretend to 'honor' the troops when in actuality they despise them. Clearly you are not one of those. If a person loathes the troops and says so, I don't really have a problem with them. Sunny-day friends I can do without, people who claim to have our best interests at heart, but only find us useful to hold up as an example to describe something they personally want.

 

[bmattock]

Let's agree to disagree and move on to topics related to rangefinder photography. I hereby yield the floor.

You're a good man. I'm sure we could find common ground on this subject as well as many others.

 

[robklurfield]

I wish encouragement meant public education, but I fear that you're right. I have trouble balancing my own idealism and cynicism. Unfortunately, the cynic in me usually wins the debate. I hope for the best and expect the worst.

I'm signing off from this debate, but I have thoroughly enjoyed your well-reasoned and cogent thoughts. Back to topics photographic for me.

Cheers

'"Encouragement" to be healthy will one day be mandated by law. I make this prediction. Others can make of it what they will, but I firmly believe I will one day be able to say "I told you so." It won't happen overnight, but it will happen. I am sorrier still that some people believe it is good and right that the government force us to take care of our bodies.""

 

[robklurfield]

The feelings are mutual. I'm afraid that, in all our heated debating, we lost poor Ruben who started the thread with some curiosity about our system and this whole mess being debated around the country. Ruben, if you're still following the thread, I hope Roger, Bill and I haven't totally confused or bored you.

You're a good man. I'm sure we could find common ground on this subject as well as many others.

 

[Olsen]

That the US constitution is a hindrance for a 'public health care' can't be true. The Norwegian Constitution of 1814 is - in idea, a copy of the American Constitution. It can't be the purpose of a Constitution to specify in detail the purpose of the government. It is the people, at all times, that makes such decisions. Trough elections.

But....

If even if the American people decided to have a wellfare state it is not economically impossible. Simply because you can't afford it. 30% of the tax income to the US Federal Government goes to paying interest of a gigantic federal debt. Within a few years 50% of all federal tax will be interest paid to debtors.

Even on State level large parts of the tax income goes to paying down debt. The debt that US taxpayers must carry is increasing fast, day by day. Even if you decided to turn this tide, - such a decision to pay down public debt in USA hasn't been taken yet, it will take you one generation - 20 years, to get it reduced to a 'handy' level. It will take you three generations to ever pay it down. - If you decide - today - to pay it down.

USA is on a streight course to a 'Argentinian situation'. Where almost all tax income goes to handling a huge debt. What does the US constitution say about this? Can US politicians write out a bill to three of four future generations? Or give 700 billion US dollars to a few thousand people - and send the bill to all the others?

The crisis now sailing up in USA is going to be so bad that you will all, - well, except for the 1% richest, be glad you have a health care system that includes all. If Obama's health bill goes through it will be a huge victory for the ordinary man & woman in USA. But this is only a tiny part of the job of reforming the US economy (and politics..?).

Over here: We are holding our breaths.

 

[bmattock]

It can't be the purpose of a Constitution to specify in detail the purpose of the government.

That is precisely what a constitution does in a republic.

http://constitutionality.us/TheConstitution.html

The purpose of the US federal government is:

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

The job of the federal government is limited and clear.

1. Form a more perfect union
2. Establish justice
3. Insure domestic tranquility
4. Provide for the common defense
5. Promote the general welfare
6. Secure the blessings of liberty

And that is all. All other powers reside with the states, or with the people.

The US Constitution also defines what the federal government may not do:

http://en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_States_Constitution

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

In other words, since the federal government has not been given the task of providing universal health care, that power resides with the states.

Over here: We are holding our breaths.

While I understand that was the US does has consequences on the rest of the world, I do not base my political beliefs or decisions on how it would impact the rest of the world. Not my problem.

 

[Olsen]

That is precisely what a constitution does in a republic.

http://constitutionality.us/TheConstitution.html

The purpose of the US federal government is:



The job of the federal government is limited and clear.

1. Form a more perfect union
2. Establish justice
3. Insure domestic tranquility
4. Provide for the common defense
5. Promote the general welfare
6. Secure the blessings of liberty

And that is all. All other powers reside with the states, or with the people.

The US Constitution also defines what the federal government may not do:

http://en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_States_Constitution



In other words, since the federal government has not been given the task of providing universal health care, that power resides with the states.



While I understand that was the US does has consequences on the rest of the world, I do not base my political beliefs or decisions on how it would impact the rest of the world. Not my problem.

Ha, ha! Sounds like good ol' filibustering to me. There must be another legal argument to be heard here. That of the people, and reason!

 

[Olsen]

While I understand that was the US does has consequences on the rest of the world, I do not base my political beliefs or decisions on how it would impact the rest of the world. Not my problem.

If the population of USA get a decent health care system or not has no consequences for us. At all. Believe me, we are following the debate about Obama's health care reform because we wish you well, and we strongly believe that this reform is to the best for you.

Not in this issue, but in the climate change issue, we all have to 'base our political decisions on how it will impact the rest of the world'.

Reading your post more carefully, I see that it is up to the individual states to run or organize any health care programs. Which is fine. Are there any state in USA that has a public health care system?

 

[bmattock]

http://en.wikipedia.org/wiki/Massachusetts_health_care_reform

http://www.boston.com/bostonglobe/e...9/03/02/mass_healthcare_reform_is_failing_us/

Mass. healthcare reform is failing us

By Susanne L. King | March 2, 2009

MASSACHUSETTS HAS been lauded for its healthcare reform, but the program is a failure. Created solely to achieve universal insurance coverage, the plan does not even begin to address the other essential components of a successful healthcare system.

What would such a system provide? The prestigious Institute of Medicine, part of the National Academy of Sciences, has defined five criteria for healthcare reform. Coverage should be: universal, not tied to a job, affordable for individuals and families, affordable for society, and it should provide access to high-quality care for everyone.

The state's plan flunks on all counts.

First, it has not achieved universal healthcare, although the reform has been a boon to the private insurance industry. The state has more than 200,000 without coverage, and the count can only go up with rising unemployment.

Second, the reform does not address the problem of insurance being connected to jobs. For individuals, this means their insurance is not continuous if they change or lose jobs. For employers, especially small businesses, health insurance is an expense they can ill afford.

Third, the program is not affordable for many individuals and families. For middle-income people not qualifying for state-subsidized health insurance, costs are too high for even skimpy coverage. For an individual earning $31,213, the cheapest plan can cost $9,872 in premiums and out-of-pocket payments. Low-income residents, previously eligible for free care, have insurance policies requiring unaffordable copayments for office visits and medications.

Fourth, the costs of the reform for the state have been formidable. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009, which is not sustainable.

Fifth, reform does not assure access to care. High-deductible plans that have additional out-of-pocket expenses can result in many people not using their insurance when they are sick. In my practice of child and adolescent psychiatry, a parent told me last week that she had a decrease in her job hours, could not afford the $30 copayment for treatment sessions for her adolescent, and decided to meet much less frequently.

 

[ebolton]

I think health care reform falls under
"5. Promote the general welfare"

That said, the Massachusetts system is a poor model. It shows why minimal reform to the existing system is futile. Total reform is necessary. Single payer is the way to go.

 

[bmattock]

I think health care reform falls under
"5. Promote the general welfare"

It does not. A simple look at the word 'promote' versus the word 'provide' should be sufficient. The framers sought to provide for the common defense, but only to promote the general welfare. Promote in this sense was meant to infer 'encourage'. If they had meant 'provide' they would have said 'provide', which is clear since they used that very word with regard to defense.

However, Alexander Hamilton believed that Article I, Section 8, (which does use the word 'provide' in connection with welfare, meant that the federal government was responsible to provide anything citizens might need or desire, up to and including food, provisions, housing, and so on. Have you ever heard of that kind of system? Oh yes, we called it 'communism'.

Hamilton's view holds sway currently in some sense, and it is also clear that a slim majority of US citizens want more of it - that is, a stronger centralized federal government, weaker states, fewer rights for US citizens. One might do well to consider that a federal government strong enough to feed and provide health care for all its citizens is also strong enough to oppress the productive segments of society and forcefully redistribute wealth in order to pay for its largess.

That said, the Massachusetts system is a poor model. It shows why minimal reform to the existing system is futile. Total reform is necessary. Single payer is the way to go.

I agree that total reform is necessary. It is not on the table in any way, shape, or form at this time. Every single bill before either house of Congress is a variation on a theme, modeled on the MA system, which as you noted, does not work.

 

[Roger Hicks]

Dear Bill,

Where are the constitutional amendments providing for the 'War on Drugs', the federal highways (if 'post roads' Article I Section 8 can be stretched that far then 'promote' can be stretched to 'provide') and the witholding (unless I remember wrongly) of federal highway funds from states that refused to raise the drinking age to 21? Or establishing old age pensions and Medicare?

Why is the constitition completely ignored in the case of West Virginia (Article IV Section 3, 'no new State shall be formed or erected within the Jurisdiction of any other State)? And in the case of the Second Amendment, if 'a well regulated Militia' is what's wanted, the only guns you can't ban are military assault rifles

Why has there never been a constitutional convention since 1787? (Though I understand the possibility is closer now than it has ever been). As far as I recall, it was one of the framers of the constitution who envisioned a convention about once a generation, because otherwise it would be like requiring a man to wear a boy's suit.

The Constitution is a convenient fig-leaf for the right wing because they can always find something in it to support their (usually outmoded) views in a late 18th century document which, although a work of towering genius, is not perfect and omniscient. Google 'Constitutional Convention 2009' and look at the alarmist right-wing drivel that is automatically called up at the head of the listings. This is another insult to the people of the United States: to assume that they are too stupid and ill-informed to do something their ancestors achieved.

Of course, if they are too stupid and ill-informed, then the United States may reasonably be deemed a failure anyway, Constitution or no Constitution.

Cheers,

Roger

 

[David Murphy]

You know I lived and worked in Europe in the 1980's and I still travel there fairly often. I've also worked in the past with EU sponsored organizations dominated by Europeans of course. Now I really love Europe, and admire it's great accomplishments in Western Civilization and so forth. However, I can't tell you how many times I've encountered culturally chauvinistic and highly educated European citizens who've been thoroughly brainwashed to think their small socialistic nanny states are the ideal model for world development. Many Americans, perhaps most, will not want or accept the infringements on their personal liberties imposed by European style socialism and statism. We find it abhorrent, and that includes "free" health care, which is not free and does not work as well as what we have here right now.

In America we have a political party currently in power that is enamored of this European Utopian statist fantasy (most of them have never actually lived under it - they hear about it at cocktail parties, where the pundits endlessly gush about the wonders of Swedish socialism and the like). Meanwhile the Chinese (and Asians in general) with a clear and positive concept of capitalism, free markets, personal responsibility, ethics, and self reliance are prospering and marching forward, with enormous productivity towards the certain promise of future riches and power. I've seen this with my own eyes too, having traveled through Asia on multiple occasions. The relative economic and social dynamism of their societies is immediate and self evident.

One thing I've always wondered about ... why have so many of my previous European colleagues immigrated to the US or Canada since the 1980's? This includes those I've known who've time-after-time touted the virtues of the European nanny state to ignorant, hick, "right-wing" Americans like me (from Texas, George Bushes state no less - gasp!). I myself may immigrate to Asia if Obama and his over-educated Utopians have their day and wreck this great nation of ours.

By way Roger, we are not "right-wingers", we are a people that place high value on self reliance and personal liberty, a way of life many Europeans cannot truly conceive and to whom it is alien.

 

[Roger Hicks]

You know I lived and worked in Europe in the 1980's and I still travel there fairly often. I've also worked in the past with EU sponsored organizations dominated by Europeans of course. Now I really love Europe, and admire it's great accomplishments in Western Civilization and so forth. However, I can't tell you how many times I've encountered culturally chauvinistic and highly educated European citizens who've been thoroughly brainwashed to think their small socialistic nanny states are the ideal model for world development. Many Americans, perhaps most, will not want or accept the infringements on their personal liberties imposed by European style socialism and statism. We find it abhorrent, and that includes "free" health care, which is not free and does not work as well as what we have here right now.

In America we have a political party currently in power that is enamored of this European Utopian statist fantasy (most of them have never actually lived under it - they hear about it at cocktail parties, where the pundits endlessly gush about the wonders of Swedish socialism and the like). Meanwhile the Chinese (and Asians in general) with a clear and positive concept of capitalism, free markets, personal responsibility, ethics, and self reliance are prospering and marching forward, with enormous productivity towards the certain promise future riches and power. I've also seen this with my own eyes have traveled through Asian on multiple occasions.

One thing I've always wondered about ... why so many of my previous Eurpean colleagues have immigrated to the US or Canada - none in the other direction. I myself may immigrate to Asia if Obama and his over-educated Utopians have their day and wreck this great nation of ours.

Dear David,

One in three of all immigrants to the United States have always returned to their own countries. These are US Government figures, on display at Ellis Island. I'm one of them. My wife Frances -- an American citizen -- is happier in Europe than in the USA (see below). A few hundred yards away in my small French village there's another American immigrant to France. One of my dearest friends in the UK left the USA decades ago. And if you listen to the BBC you'll hear a remarkable number of American accents from emigrés.

If the Chinese have a clear and positive idea of capitalism, that's rather interesting: they call it communism, and in some ways (control of the media in particular) it is more akin to fascism.

What restrictions on personal liberty do I suffer by living in France, as compared with the USA? If America is so free, why did it ban travel to Cuba?

When Frances was diagnosed with breast cancer in 2000, she did not break down in tears until an hour or so later. When the nurse tried to comfort her, she said, "These are tears of relief. If I were in the United States I'd be facing bankruptcy as well as cancer. As it is, I'm only facing cancer..." If you really think the current US health care system is better than the French, words fail me.

By the way, David, only the right wing in Europe begins to express views like yours. To use a similar spin to yours, here in Europe most of us believe in helping our fellow man, not on letting him go to hell because he's not as rich or successful as us. And I'd rather be over-educated than under-educated.

Tashi delek,

R.